Escaping captivity: Psychological chains are longer lasting

Three women have been rescued in Cleveland after being held captive for about a decade. But some experts say the hard times aren't over yet.

"ALIVE AND SAFE" screamed the front page of the Cleveland Plain Dealer, announcing the recovery of three women from a private home in the city's western district.

It was a happy ending to what is becoming an increasingly disturbing story. Amanda Berry, Gina DeJesus and Michelle Knight spent about a decade trapped in the home. Three men - Ariel Castro and his brothers, Pedro and Onil - are being questioned.

But of course, it's not really the end.

"It's not over by a long shot," says Herb Nieburg, associate professor of law and justice policy studies at Mitchell College in New London, Connecticut.

"There is a tremendous number of hours in terms of counselling and working with them for treatment of post-traumatic stress disorder."

This will be with them for a long time, and possibly foreverPeter Suedfeld,, Psychologist

While the women - two of whom, Berry and DeJesus, were kidnapped as teenagers - are out of physical danger, it will take much longer to make them psychologically whole.

That's because the tactics used by abductors in cases such as these are designed to make their captives feel worthless, powerless and afraid.

"Victimised women are separated by their captors from all of the people and experiences that they've had that would contribute to a) self-esteem and b) their self confidence and their identity," says Rona Fields, psychologist, sociologist and author of Against Violence Against Women: The Case for Gender as a Protected Class.

She says these patterns play out around the world, whether in Afghanistan, China or in the US.

"Relationships with their families of origin have been destroyed," she says. "The young woman captive has a sense that she's been abandoned and that she's been rejected."

Police have confirmed that the six-year-old girl found in the house was Amanda Berry's daughter. The girl was apparently born while her mother was being held.

The sexual abuse stigma

Earlier this week, Elizabeth Smart spoke at a forum on human trafficking at Johns Hopkins University, drawing a line between her religious upbringing and the shame she felt after being sexually abused.

She said during her abduction she dwelt on lessons comparing sexually active people to chewed gum.

"I thought 'Oh my gosh, I'm that chewed up piece of gum, nobody re-chews a piece of gum. You throw it away.' And that's how easy it is to feel like you no longer have worth, you no longer have value," she said. "Why would it even be worth screaming out?"

But Nieburg says while this stigma is greater in religious circles, US culture as a whole creates an unfair and unwitting stigma around victims of sexual abuse.

"Every young woman grows up early on to think that being sexually active is not the thing your family wants for you," he says.

There were also unconfirmed reports that the other two women had suffered abuse and beatings.

This mix of sexual and physical violence can further contribute to a sense of danger, a learned obedience and a damaged psyche that can linger after the abuse ends.

"The sexual abuse is humiliating, demeaning, makes you feel not very good about yourself," says Nieburg. "It instils a sense of hopelessness."

That mix has been on display in previous cases of missing girls, most notably Elizabeth Smart and Jaycee Dugard.

Smart was 14 when she was taken from her bed in the middle of the night by Brian David Mitchell, who claimed her as his bride and repeatedly sexually assaulted her over a nine-month period. Dugard was kidnapped by Phillip Garrido on her way to school at age 11, and imprisoned for 18 years, giving birth to two children in the process.

Both Smart and Dugard had several opportunities to draw attention to themselves and their captors. Mitchell took Smart to parties in the Salt Lake City area, and they ate together at restaurants. Dugard spoke to Garrido's parole officer and worked at his printing business.

When finally confronted by law enforcement, it took time and pressure for both women to admit their true identities.

Such a situation is not uncommon among those who have been held against their will for long periods of time.

"Usually there is some physical restraint, but eventually that's substituted for by the techniques similar to what cults use: mind control, threats," says Nieburg.

Victims can lose their sense of perspective after years of abuse.

"There can be such a wide range of abuse that a victim who is no longer viciously abused may feel gratitude" towards their captor, says Peter Suedfeld, professor emeritus of psychology at the University of British Columbia.

"On the other hand, they're also afraid that if they try to escape and fail, all those conditions which are at the moment tolerable will become intolerable."

Indeed, Dugard told Diane Sawyer that she didn't try to escape because: "What I knew was safe. The unknown out there was terrifying."

They may feel overwhelmed by public displays of support

Berry did try to escape - and in doing so, was able to free herself, her daughter, and the two other women in the house.

Her call to 911 may have been telling. "I'm Amanda Berry," she said. "I've been on the news for the last 10 years."

That sense of self - and that people were looking for her - may have helped give her the confidence to leave.

"There is a sense of abandonment if you think the search has stopped," says Suedfeld, and that fear is often played up by abductors, who tell captors their families have stopped looking.

But Berry knew she hadn't been forgotten, and that may have given her the strength to fight for freedom.

Nevertheless, women who are rescued from this type situation are never fully free - not at first. The damage inflicted on them by their captors takes years to address.

"This will be with them for a long time, and possibly forever," says Suedfeld. "They are going to have nightmares. They may feel suspicious of other people, strangers, men in particular."

They will have to readjust from a life in captivity to a life in the real world, complete with sounds, smells and people crowding around them.

"They are basically bombarded with stimulation after a long time of having very little," he says.

For Austrian Elisabeth Fritzl, who escaped from a basement cell where she was raped by her father for 24 years, one of the hardest transitions was living with full lighting and spacious rooms.

It took 10 years for the three women in Cleveland to find their way out of the door and into the light. And it may take them many more years to adjust to the change.